Questions surround new state meth treatment program

Published 6:00 pm, Sunday, January 20, 2008

A $2 million state program that offers an obscure medical therapy touted as a cure for methamphetamine addiction has yet to get off the ground, and some experts question whether Texas should be involved in an unproven treatment.

The $1 million-per-year pilot treatment program was added to the Texas budget last year with little notice and no objection.

The drug therapy, called Prometa, is a costly combination of drugs and nutritional supplements each approved by the Food and Drug Administration individually, but never evaluated as a combination to treat substance abuse. Many drug treatment experts fear that the regimen was rushed to market and that Texas lawmakers fell for the marketing pitch, The Dallas Morning News reported Monday.

But officials of Hythiam Inc., the company that licenses Prometa, say they are not marketing the medication _ that they're merely selling information to doctors. Once the FDA approves a drug, a doctor can prescribe it for anything, but it can only be marketed for its original purpose.

The Prometa protocol is still awaiting the results of several major clinical studies.

The state Prometa program was intended to curb meth addictions in the largest counties, particularly in North and East Texas. But when state probation officials offered up the money to local adult probation departments, hardly a single large county bit.

Several smaller probation departments have applied to offer the drug therapy as a condition of release for convicts. State officials awarded more than $500,000, about half of what they intended to spend this year on the program, to Collin, Lubbock, Caldwell and Nueces counties.

"To invest time and money on Prometa at this time, in my opinion, is premature," Dallas criminal district Judge John Creuzot wrote in a July e-mail to the director of the Texas Department of Criminal Justice.

Creuzot refused to participate in the program. He suggested that the buzz about Prometa was "lore and perceptions" and warned of possible lawsuits if "someone is hurt or injured because of Prometa."

He said money shouldn't be spent on something that hasn't been clinically researched to be safe and effective. He said the company marketing the treatment "did a great sales job on some well-intended legislators in Texas."

Rep. Jerry Madden, the House Corrections Committee chairman who requested funding for the program, said only time and results will show whether Prometa does what its supporters say. An ardent advocate for rehabilitation, Madden, a Plano Republican, said he won't take criticism for trying a treatment many addicts swear by.

In the meantime, Madden has been fielding calls from Wall Street investors and his name has been used as a seal of approval on Prometa marketing materials. Madden says he has no financial ties to the company.

The statewide pilot "is really just to see if it works or not," Madden said.

Early tests are promising but limited.

In a 20-person Prometa pilot program in Collin County last year, funded by the treatment company, 16 felony meth offenders were clean after 90 days, Collin County District Judge Charles Sandoval said. He called it a "spectacular" success rate, far higher than the state's current drug therapy.

A growing number of doctors vouch for Prometa's effectiveness. Dallas psychiatrist and addiction specialist Harold Urschel III said he'd been treating meth users for more than a decade with little success when he tried it.

"Use went down. Cravings dropped dramatically," he said.

However, Kathryn Cunningham, director of the University of Texas Medical Branch's Center for Addiction Research, said it's true that some medical treatments can alter brain chemistry to curb drug cravings, but there's little proof Prometa is one of them.

"There's been a lot of marketing hype before the evidence exists. This is not something I'd personally want to spend my taxpayer money on," Cunningham said.

When Terren Peizer sent the Prometa protocol to market in 2003, the former junk bond salesman and financier didn't have stacks of clinical studies or government approval to market the drug protocol for addiction. What he had was $150 million in capital _ and complete confidence that the three drugs a Spanish psychologist combined in the 1990s to treat substance abuse worked.

Today, 2,500 people have been treated with Prometa and 70 doctors offer it. Several U.S. cities including Las Vegas offer the therapy through probation departments or drug courts.